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26
FEATURE
and check they have built patient
understanding. Unfortunately some of
the standard questions used at this point,
such as ‘Do you have any questions?’ or
‘Do you understand?’ are often ineffective
at uncovering things that have been
misunderstood or unclear. These type
of questions tend to generate a ‘No’ or
‘Yes’ answer rather than a discussion of
the topic. This may be because a patient
thinks they have understood what has
been said, or is struggling to formulate a
specifc question. More effective checking
uses questions or demonstrations such as
“I just want to check I have been clear,
what exercise are you going to do to
strengthen your pelvic foor when you get
home?”
Written and oral information is
not enough—even if the written
information has visuals
All written information benefts from
contextualisation for the recipient. In the
same way that physiotherapists show you
the exercises they want you to do, you
need to demonstrate the techniques for
your patient. Suggest your patient takes
a photo or a video on their phone as you
demonstrate the exercises.
Health professionals have spent
years becoming fuent in a new
language—medicine speak
Unfortunately most of us aren’t fuent
in this new language. Especially when the
terms used include words that also have
an everyday meaning, such as ‘foor’. We
often tell the story of a patient we met
who was waiting to see his GP about his
diabetes because he didn’t want to see the
practice nurse because he didn’t want a
student who would practise on him.
There are a range of options
You can ask people what they already
know about a subject: “I am going to get
you to do pelvic foor exercises after you
are discharged. Tell me what you know
about your pelvic foor.”
Or you could just explain the terms you
use, "When you go home I want you to
do some exercises for your pelvic foor
muscles. Your pelvic foor muscles are a
group of muscles... Usually women have to
do pelvic foor muscles after childbirth but
the same sort of exercises are useful after
the surgery you have had.”
It’s okay to ask the patient to
demonstrate what they need to do
If treatment is not going as expected,
then check what the patient is doing by
asking them to show you. And if you fnd
that your instructions weren’t that clear
in the frst place—or that you made an
assumption—then frst take responsibility
for not being clear, and apologise to the
patient.
Some of you may remember the episode
of House where he interviewed a patient
whose asthma was still problematic. Dr